AUGUST 2013 - New Zealand Doctor

RNZCGP Review of the delivery of general practice vocational training August 2013Option 6: Workplace assessmentsPoints for consultation1. That the current workplace assessments continue but the format of these is adjusted to fit with thechanges in immersion teaching.2. A ‘pool’ of assessment resources is created for use by registrars requiring remedial assistance orwhere there is a break-down in the teacher/registrar relationship.3. That the feasibility of using video conferencing to complete workplace assessments be investigated,including the use of technology to observe patient consultations.The current format of a workplace assessment is based around consulting style, communicationskills, integration into a practice, educational activities and the learning portfolio of the registrar,and it provides a format for the future Fellowship assessment visit. If there is a wider spread of theworkshop/seminar delivery over the three years of training, registrars will initially have less contactwith their ME.If the 50:30:20 model educational delivery is adopted there would be potential for an increase in thenumber of visits during GPEP training, despite this being only 5% of the overall educational delivery.Option 6.1 (status quo): One registrar per visitCurrently an ME visits a single registrar within the registrar’s practice and consults with the registrar,in-practice supervisor, other practice staff and observes patient consultations.Option 6.2: Multiple registrars per visitIf there are several registrars in one practice, assessments could be combined on one day. Thework of reviewing the general practice setting and discussions with the in-practice teacher would beshared over several registrars and produce time and cost savings.Option 6.3: Virtual visitsFor registrars who are excelling in their practice setting, or who have been in the same practiceor group of practices for an extended period of time, there is the option to complete workplaceassessments virtually. This could occur where the visiting ME is comfortable that there is little to begained from physically visiting the practice, but that all objectives of the visit can be achieved bytalking to the teacher and the registrar online.Option 6.4: Remedial visitsTwo concerns are often addressed by external visitors - under-performing registrars anddysfunctional relationships between registrar and teacher. In such cases, there must be theopportunity for extra visits.While the allocation of hours between educational components allows a number of workplaceassessments per registrar, an option is required to allocate each registrar fewer visits and “pool” theremaining visits for use in these situations. Depending on the objectives of these visits, some visitscould be completed via an internet video conference.35